Surgical clip assembly



April 23, 1963 H. c. EBY

SURGICAL cup ASSEMBLY Filed Oct. 6, 1960 4 Sheets-Sheet 1 5 April 23,1963 H, c, EBY

SURGICAL CLIP ASSEMBLY 4 Sheets-Sheet 2 Filed 001;. 6, 1960 INVENTORAQ/P/PY 62/?042059) April 23, 1963 H. c. EBY

SURGICAL CLIP ASSEMBLY 4 Sheets-Sheet 3 Filed Oct. 6, 1960 k LII.

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SURGICAL CLIP ASSEMBLY 4 Sheets-Sheet 4 Filed Oct. 6, 1960 l N VE NTO R//4,P/Py Cza aw 5a) United States Patent 3,086,208 SURGICAL CLIPASSEMBLY Harry Cliiford Eby, Meadville, Pa., assignor to Ethicon, Inc.,a corporation of New Jersey Filed Oct. 6, 1960, Ser. No. 60,977 Claims.(Cl. 1--56) This invention relates to a skin clip assembly adapted foruse in loading an applicator which may then be used by the surgeon forclosing incisions or lacerations in flesh. It is a major object of myinvention to provide a loader package of skin clips wherein the skinclips are held together on a carrier for loading into an applicator.

An additional object of my invention is to provide a clip holder orstrip adapted to assemble a group of clips in alignmeent as a unit whichcan be easily inserted in an applicator.

Another object of the invention is to provide a loader package wherein anumber of clips are held in alignment by a metal strip in such a mannerthat the metal strip may be slidably removed from the applicator afterloading.

These and other objects of my invention will become apparent from thefollowing detailed description of a preferred form thereof and from aninspection of the accompanying drawings, in which:

FIGURE 1 is a plan view of a skin clip.

FIGURE 2 is an edge elevation of the left-hand side of the skin clipillustrated in FIGURE 1.

FIGURE 3 is an edge elevation of the right-hand side of the skin clipillustrated in FIGURE 1.

FIGURE 4 is a perspective view of a clip holderand clips mountedthereon.

FIGURE 5 is an enlarged fragment of FIGURE 4.

FIGURE 6 is a perspective View of the clip holder shown in FIGURE 4.FIGURE 7 is an edge elevation of a skin clip mounted on a clip holdertaken on the line 7-7 of FIGURE 5 FIGURES is an enlarged horizontalcross-section taken on line 8-8 of FIGURE 5.

FIGURE 9 shows a much enlarged transverse crosssection taken on line 99of FIGURE 5.

FIGURE 10 is a plan view of a semi-automatic clip applicator which maybe loaded with the clip assembly of the present invention.

FIGURE 11 is a plan view of the clip applicator shown in FIGURE 10, butwith the body open for loading with a clip assembly and for exposure ofthe interior thereof.

FIGURE 12 is a side view of the clip applicator shown in FIGURE 10.

FIGURE 13 issa side view of the clip applicator shown in FIGURE 10 butopened for loading as in FIGURE 11.

FIGURE 14 is a bottom view of the clip applicator shown in FIGURE 10.

FIGURE 15 is a sectional view taken along the line 1515' of FIGURE 10.

FIGURE 16 is a side sectional view of the front portion of the clipapplicator with the clip release lever out of clip retaining position.

FIGURE 17 is a sectional view taken on the line 17-17 of FIGURE -1 6.

FIGURE 18 is an elevation view taken on the line 18-1-8 of FIGURE 15.

FIGURE 19 is a sectional view taken on the line 19-19 of FIGURE 15.

FIGURE 20 is a sectional view taken on the line 2020 v of FIGURE 15.

FIGURE 22 is a sectional view taken on the line 22-22 of FIGURE 15.

contact the carrier at three different points and are held in alignmentto facilitate easy insertion of the assembly into the magazine of asemi-automatic applicator. When the applicator has been loaded, thecarrier may be withdrawn leaving the skin clips in position for use inthe applicator magazine.

The Skin Clip An important feature of this invention resides in theclips which are assembled together to provide a loader package. As seenin FIGURES 1, 2 and 3, the clip 10 is formed of sheet material,preferably metal, and in this particular embodiment, the body is planarand generally U-shaped with a rear web portion 11 and forwardlyextending leg portions 12. The end of each leg portion :18 projectsinwardly and downwardly to form the pointed tines 20. The center 16 ofthe web portion 11 is reduced in cross-section. With these arrangements,pressure on the sides of the clip sufficient to bend the leg portions 12would cause the tines 20 on the legs to move toward each other. When theclip is pressed onto a wound, pressure on the sides of the clip causesthe tines to penetrate the skin to bring the margins together, seeFIGURE 24.

The Skin Clip Assembly The clips may be assembled together on a carrierto form a unit as illustrated by FIGURE 4. As seen in FIGURE 6, thecarrier 22 is a long strip of metal formed with a finger grip 24 and alongitudinal rib 30. The width of the rib 30 is slightly less than thedistance between the tines 20 of the skin clip. Upturned punched tabs 26project beyond the top surface of the rib 3'0 and are spaced to engagethe web section of consecutive skin clips. The individual clips 10 arespaced along the strip in a straight line in end to end relationship,with the ends of the legs of one clip slightly spaced from the rear 'ofthe web portion of the next clip as shown in FIGURES tains the websection in contact with the surface 34 of the rib.

The Applicator It is necessary to describe in some detail thesemi-automatic clip applicator in order to appreciate the functioning ofthe skin clip assembly during the loading procedure. Referring now toFIGURES 10 through 14, the instrument, indicated generally by thereference numeral 13 comprises a body 15. The body is formed from twosections 14 and 19 pivotally connected together on trunnions 21. Withthis arrangement, the body sections can be pivoted apart so theinstrument can be loaded with clips.

As best seen in FIGURE 12, when in use, the body is arranged so thatsection 19 overlies section 14, and these sections are releasably heldtogether by a spring clamp assembly. This spring clamp assembly includespivotally mounted lever members 27 and a spring clamp 33, see FIGURES10, 14 and 17.

The spring clamp 33 is a generally U-shaped member including a webportion 23 and upwardly extending leg portions 25 terminating ininturned flanges 45. The web portion is riveted to the base of section14 and the leg portions 25 embrace the sides of sections 14 and 19, seeFIGURES 12 and 13. As seen in FIGURE 10, the inturned flanges 45 embracethe top surface of body section 19, and this is what holds the bodysections together. To open the body, levers 27 are pressed, and as seenin FIGURE 17, this will force leg portions 25 apart until fianges 45 nolonger embrace the top surface of section 19, whereupon sections 14 and19 can be pivoted open and the instrument can be loaded with clips.

The body 15 is provided with a magazine for receiving a number of clips.This magazine includes a recess or guideway 28 formed in the uppersurface of section 14, see FIGURES 11, 15 and 22. As seen in FIGURES 17,21 and 22, the guideway 28 slidably supports the sheet surface of thebody of the clips.

The body also has means for urging the clips through the guideway towardthe front end 47 of the instrument. In this particular embodiment, thiscomprises a spring '49 and a push member 51 slidably mounted in a groove36 formed in surface 37 of section 16, see FIGURES 11 and 22. As seen inFIGURES 17 and 21, the front end 35 of the push member is bifurcated forreasons to be described below. In addition, as seen in FIGURES 15, 16and 17, the front end 35 of push member 51 abuts against the rear edgeof the rear clip in the magazine and spring pressure forces the clipstoward the front of the instrument.

Section 19 of body 15 is provided with an enlongated slot 38 extendingalong a substantial portion of the length of section 19 with a smallbent portion 39 at the rear. 'A pin 40 with an enlarged head 41 extendsthrough slot 38 and is rigidly secured to push member 51, see FIGURES 15and 16. This structure provides a means for holding the push member 51in a retracted position out of contact with the clips. This is done bypushing pin 40 to the rear end of slot 38 and rotating it into the bentportion 39, as seen in FIGURES l1 and 23.

With the push member 51 held in a retracted position, the instrument canbe loaded by opening the body of the instrument as shown in FIGURE 11.Then an assembly of clips, see FIGURE 4 is dropped into guideway 28 andthe body is closed and the carrier strip 22 withdrawn, leaving the clips10 in position. Finally, pin 40 is rotated out of the bent portion 39 ofslot 38 and is released to move under pressure of spring 49 against therear edge of the last clip in the magazine, as shown in FIGURE 15.

The front end of the top surface 17 of section 19 is beveled slightlyand a spring-biased lever assembly, including a flat spring 44 and aconnected clip-releaselever member 46, is mounted thereon, see FIGURES land 16. An opening 48 extends through section 19 from top surface 17 andan abutment 50 depending from lever member 46 extends therethrough to apoint in the path of clips moving along guideway 28. As seen in FIG- URE'16, pressure 'on lever member 46 causes the abutment 50 to rise out ofthe path of the clips 10 in a guideway for reasons to be describedbelow. When pressure on lever member 46 is removed, spring pressureforces lever 46 and abutment 50 back to the position shown in FIGURE 15.

A pair of forceps, indicated generally by the reference numeral 52, ismounted on the body extending out beyond the front end thereof, seeFIGURES 11 and 17. The forceps include a pair of resilient metal strips54 and 56 mounted on the opposite sides 58 and 60 of the body section14. The front ends of these strips are bent toward each other to formjaw abutments 62. These jaw abutments have an upwardly extending recessforming seats 63, as seen in FIGURE 15. These seats function to supportand engage the front edge of the clip next to be applied by theinstrument, see FIGURES 16 and 17. The jaw abutments are positioned inadvance of the front end of the guideway a distance substantially equalto the length of the individual clips, for reasons to become apparentbelow.

Oppositely extending cylindrical press members 64 are secured to thesides of strips 54 and 56 whereby pressure can be conveniently exertedon the forceps. A channelshaped member 66 secured to the under surfaceof section 14 embraces the sides of strips 54 and 56 and prevents thejaw abutments 62 from moving more than a fixed distance apart againstthe pressure exerted by the resilience in the strips 54 and 56, seeFIGURES 14, 18 and 19. As seen in FIGURE 17, the fixed distance is equalto the width of an individual clip. This permits the forceps to hold theclip when the instrument is not in use.

The assembly of clips is conveniently installed as a unit inside themagazine of the applicator as shown in FIG- URE 25. After the housing isagain closed, a gently pulling force on the metal stop is suflicient towithdraw it from the applicator, leaving the clips all properlypositioned inside the instrument. It will be understood that the slightspacing between the clips contributes to the ease of removing the metalcarrier. If the clips are assembled with the ends of the legs of oneclip abutting against the rear of the web portion of the next clip, theforce required to withdraw the carrier will be much greater than theclips may jam in the magazine.

In operation, after the clips are inserted inside the in-* strument, thepressure exerted by the spring 49 on push member 51 forces the train ofclips toward the front of the instrument until the front of the webportion of the first clip in the train engages abutment 50. Then amomentary pressure on lever member 46 is suflicient to move abutment 50out of the guide path of the clips, permitting the push member to movethe clips forwardly until the front edge 18 of the clips engage seats63, see FIGURE 17. At the same time, it is noted that the rear edge ofthe web portion 11 is supported on the front end 29 of the guideway 28.This arrangement, when coupled with the pressure exerted on the frontclip by spring 49 is sufiicient to hold the body of the clip in advanceof the body of the instrument, see FIGURE 17. In this position, themargin of the wound is clearly visible between the legs 12 of the clips10, so that the clips can be positioned more accurately.

In applying the clips, the instrument is placed against the wound withthe points 20 of the clips 10 properly positioned. Then pressure isexerted on press members 64. This forces jaw abutments 62 toward eachother, bending the legs 12 of the clip. The points 20 which aredownwardly inclined and which extend toward each other, penetrate theskin around the wound. Then when pressure on press members 64 isremoved, the jaws 62 move apart due to the resilience in strips 54 and56. This leaves the clips 10 embedded in the skin to hold the woundmargins together and out of the instrument, as shown in FIGURE 24.

It is noted that after a clip has been used, the remainder of the clipsin the magazine are prevented from moving along guideway 28 because ofthe abutment 50 in their path. Consequently, in order to permit the nextclip to advance into engagement with the seats 63 on the jaws 62, levermember 46 must again be pressed. This is a useful feature because itkeeps all the clips enclosed in the housing 12 until they are to beused. Otherwise, the next clip in the magazine would automaticallyadvance to the front position, as shown in FIGURE 17, where it could bedislodged from the instrument or damaged by accidental jars or blows,while the instrument is not in use.

When the last clip in the instrument is to be used, lever member 46 isagain momentarily pressed and the push member 51 can then force thislast clip into seating position on the jaws. Because the front end 35 ofthe push member 51 is forked, release of lever member 46 does notprevent the front end of the push member 51 from moving to the front end29 of the guideway in order to maintain enough pressure on the last clipto keep it seated in the jaw abutments and ready for use.

As seen in FIGURE 9, the points 20 of the clips 10 extend downward fromthe surface of the body of the clip. Since the clips slide alongguideway 28 on the surface of their body, the guideway must be shaped sothe points do not rub against any surface of the guideway or any otherpart of the body of the instrument as the clips are pushed along. Thisis done 'by forming a groove, recess, or opening 31 in guideway 28designed to keep the points 20 out of rubbing contact with the guideway,see FIGURES 16 and 21.

The fact that the points 20 of the clips 10 are downwardly inclined fromthe body of the clip and the instrument, see FIGURES l and 16, isimportant because when the instrument is used to apply clips to thewound, the instrumentneed only be held at a comparatively small anglewith the surface of the wound. This substantially eliminates theapplication of pressure on the wound which might otherwise be necessaryif the points were generally in the plane of the body of the instrumentso that the instrument would have to be applied to the wound at asubstantial angle, e.g., in excess of 45 The invention may be embodiedin other forms without departing from the spirit or essentialcharacteristics thereof as set forth in the claims, and the presentembodiment is therefore to be considered as illustrative and notrestrictive and it is intended to include all changes which come withinthe scope and range of the claims. The applicator and skin clipdescribed herein are claimed in copending application Serial No. 10,595,filed February 24, 1960.

What is claimed is:

1. A skin clip carrier for a series of skin clips each having agenerally U-shaped body with spaced pointed leg portions and aconnecting web portion, the carrier comprising a fiat strip of metalhaving a central upstanding rib to support the clip web portions andlaterally extending side flanges to support the clip leg portions, therib having spaced upwardly projecting spring ears extending over theclip web portions to removably retain the clips in position on thecarrier.

2. A skin clip carrier for a series of skin clips each having agenerally U-shaped body with spaced pointed leg portions and aconnecting Web portion, the carrier comprising a flat strip of metalshaped to have a longitudinal rib and laterally extending side flanges,the width of said ri-b being slightly less than the distance between thepointed leg portions of said clip, and upwardly projecting spring earsspaced along said rib to removably retain the clips in position on thecarrier.

3. A skin clip carrier for a series of skin clips each having agenerally U-shaped body with spaced pointed leg portions and aconnecting web portion, the carrier comprising a fiat strip of metalshaped to have a longitudinal rib and laterally extending side flanges,the width of said rib being slightly less than the distance between thepointed leg portions of said clip, and upwardly projecting spring earsspaced along said rib at distances slightly greater than the length ofsaid clip.

4. A skin clip carrier comprising a fiat strip of metal shaped at oneend to form a finger grip, a central upstanding rib extending from thefinger grip to the opposite end of the strip and upwardly projectingspring ears evenly spaced along the length of said rib.

5. A skin clip carrier for a series of skin clips each having agenerally U-shaped body with spaced pointed leg portions and aconnecting web portion, the carrier comprising a flat strip of metalshaped at one end to form a finger grip, and extending from the fingergrip to the opposite end of the strip a central upstanding rib tosupport the clip web portions, said rib having spaced upwardlyprojecting spring ears extending over the clip web portions to removablyretain the clips in position on the carrier.

References Cited in the file of this patent UNITED STATES PATENTS934,486 Walling Sept. 21, 1909 2,135,279 Dickinson Nov. 1, 1938 FOREIGNPATENTS 456,285 Great Britain Nov. 2, 1936

1. A SKIN CLIP CARRIER FOR A SERIES OF SKIN CLIPS EACH HAVING AGENERALLY U-SHAPED BODY WITH SPACED POINTED LEG PORTIONS AND ACONNECTING WEB PORTION, THE CARRIER COMPRISING A FLAT STRIP OF METALHAVING A CENTRAL UPSTANDING RIB TO SUPPORT THE CLIP WEB PORTIONS ANDLATERALLY EXTENDING SIDE FLANGES TO SUPPORT THE CLIP LEG PORTIONS, THERIB HAVING SPACED UPWARDLY PROJECTING SPRING EARS EXTENDING OVER THECLIP WEB PORTIONS TO REMOVABLY RETAIN THE CLIPS IN POSITION ON THECARRIER.